Head CT Scan Use Has Doubled In U.S. ERs

Posted November 20, 2025

Head CT Scan Use Has Doubled In U.S. ERs

Use of head CT scans in U.S. emergency departments has more than doubled over the past 15 years, a new study says.

Nearly 16 million head CT scans were ordered by ERs in 2022, up from under 8 million in 2007, researchers reported Nov. 17 in the journal Neurology.

“Head CT scans are a critical tool for diagnosing neurological emergencies, but their growing use raises concerns about cost, radiation exposure and delays in the emergency department,” lead researcher Dr. Layne Dylla, an assistant professor of emergency medicine with Yale School of Medicine in New Haven, Connecticut, said in a news release.

CT scans are critical when responding to emergencies like strokes, but are less helpful when diagnosing problems like headaches, seizures or dizziness, researchers said.

In those situations, CT scans add little value but bring additional cost, slow down treatment, and expose patients to unnecessary doses of radiation, researchers said.

“It’s important to balance the benefits of these scans with the risks and costs,” Dylla said.

For the new study, researchers analyzed CT scan use as reported to a national hospital database.

Results showed that by 2022 more than 10% of all ER visits involved a head CT scan, up from under 7% in 2007.

The data also revealed disparities in who got these scans:

Black people were 10% less likely to get a head CT scan than white people.
Medicaid patients were 18% less likely to get a scan than those on Medicare or private insurance.
Rural hospital patients were 24% less likely than urban patients.
Seniors 65 and older were six times more likely to get a head CT scan than children younger than 18.

“Overall, these results highlight the need for more equitable access to neuroimaging in emergency care and further evaluation of the appropriateness of every head CT according to clinical recommendations,” Dylla said.

“It’s important to recognize the tension between underuse of scans, leading to missed diagnosis, and overuse, resulting in radiation exposure and additional financial and patient care strains on the health care system,” Dylla added.

In an accompanying editorial, European radiology experts agreed that there are many potential consequences from overuse of CT scans.

“Patients face unnecessary radiation exposure, which is not a trivial concern,” wrote the team led by Dr. Alex Rovira, chair of the referral guidelines subcommittee of the European Society of Radiology.

“A recent JAMA Internal Medicine study estimated that the 93 million CT scans performed in the United States in 2023 could lead to more than 100,000 future cancers, potentially representing up to 5% of all new diagnoses each year if current trends continue,” the team wrote.

“Educational research shows that the roots of overuse begin when clinicians are in training,” they added. “A study simulating medical students’ first day of residency revealed systematic overordering of imaging, with nearly 70% of cases involving unnecessary abdominal CT scans or chest X-rays, exposing more than a third of patients to significant avoidable radiation.”

More information

The University of Texas MD Anderson Cancer Center has more on CT scans and cancer risk.

SOURCES: American Academy of Neurology, news release, Nov. 19, 2025; Neurology, Nov. 19, 2025